Background: Bilateral breast reduction (BBR) yields significant psychological and physical benefits for women. However, New Zealand’s public healthcare sector faces substantial resource constraints, exacerbated by a low per-capita ratio of plastic surgeons. In the Waikato region, nine specialists cater to a population of approximately 496,700 (1,2,3). This study evaluates a retrospective service review of BBR procedures to determine if public-to-private outsourcing effectively improves service accessibility.
Methods: Data for BBR procedures (ICD block 1754) performed by the Waikato Plastic Surgery Department between 1 July 2017 and 31 December 2024 were extracted via CostPro software. A total of 169 patient discharges were identified and analysed for waiting times, surgical location, and clinical outcomes.
Results: Procedures were distributed across Waikato Hospital (n=104, 61.54%), Thames Hospital (n=11, 6.51%), and private facilities including Braemar (n=29, 17.16%), Anglesea (n=24, 14.2%), and Southern Cross (n=1, 0.59%). A significant shift toward private outsourcing occurred between 2022 and 2024, with 36 cases completed in private hospitals compared to 17 in public. While mean waiting times peaked at 23.2 months in 2023 (up from 8.2 months in 2017), the increased outsourcing in 2024 successfully reduced this to 20.2 months. The mean waiting time specifically for outsourced private patients was 15.3 months. Complication rates in private facilities were comparable to public settings, with an average length of stay of 1.3 days (range 0–5).
Conclusion: This eight-year review demonstrates that while public BBR capacity is limited by funding and staffing shortages, private sector collaboration offers a safe and effective mechanism to mitigate the post-pandemic healthcare crisis. Implementing this public-private partnership model beyond Waikato could significantly enhance surgical access for women nationwide.